The following is a series of studies performed in Sri Lanka to understand the cause of the high incident rate of Chronic Kidney Disease of uncertain aetiology (CKDu) in the North Central province of the country. There are high fluoride levels in the drinking water in the same area. The latest paper by Jayalal et al. (2020) reported very high fluoride and lead levels in cadaver bone of those who died of CKD. In 2019, Jayalal noted, “The phenomenon of fluoride being known to increase the absorption of lead may be playing a synergistic role in this situation as it had been reported that fluoride concentration in water in the CKDu affected areas is higher.”

To keep updated on the the new studies, check in at http://fluoridealert.org/tag/sri-lanka/


  1. By Jayalal T, et al. Evidence of selected nephrotoxic elements in Sri Lankan human autopsy bone samples of patients with CKDu and controls. BMC Nephrology.

 

  1. By Nanayakkara S, et al. The Influence of fluoride on chronic kidney disease of uncertain aetiology (CKDu) in Sri Lanka. Chemosphere.

 

  1. By Perera Tet al. Experimental rat model for acute tubular injury induced by high water hardness and high water fluoride: efficacy of primary preventive intervention by distilled water administration. BMC Nephrology.

 

  1. By Pinto U, et al. Water quality and chronic kidney disease of unknown aetiology (CKDu) in the dry zone region of Sri Lanka: impacts on well-being of village communities and the way forward. Environmental Science and Pollution Research.

 

  1. By Fernando W, et al. Serum and urine fluoride levels in populations of high environmental fluoride exposure with endemic CKDu: a case-control study from Sri Lanka. Environmental Geochemistry and Health.

 

2019. By Jayalal T, et al. A quantitative analysis of chronic exposure of selected heavy metals in a model diet in a CKD hotspot in Sri Lanka. BMC Nephrology.

 

  1. By Sayanthooran S, et al. Transcriptome analysis supports viral infection and fluoride toxicity as contributors to chronic kidney disease of unknown etiology (CKDu) in Sri Lanka. International Urology and Nephrology.

 

  1. By RW Dharmaratne. Fluoride in drinking water and diet: the causative factor of chronic kidney diseases in the North Central Province of Sri Lanka. Environmental Health and Preventive Medicine.

 

  1. By Hallett BM, et al. Mineralogical sources of groundwater fluoride in Archaen bedrock/regolith aquifers: Mass balances from southern India and north-central Sri Lanka. Journal of Hydrology: Regional Studies.

 

  1. By K Wanigasuriya. Update on uncertain etiology of chronic kidney disease in Sri Lanka’s north-central dry zone. MEDICC Review.

 

  1. Chandrajith R, et al. Chronic kidney diseases of uncertain etiology (CKDue) in Sri Lanka: geographic distribution and environmental implications. Environmental Geochemistry and Health.

 

2011.By Chandrajith R, et al. Dose-dependent Na and Ca in fluoride-rich drinking water–another major cause of chronic renal failure in tropical arid regions. The Science of the Total Environment.

 

  1. By Bandara JM, et al. Chronic renal failure among farm families in cascade irrigation systems in Sri Lanka associated with elevated dietary cadmium levels in rice and freshwater fish (Tilapia). Environmental Geochemistry and Health

 

  1. By Ekanayake L and van der Hoek W. Dental caries and developmental defects of enamel in relation to fluoride levels in drinking water in an arid area of Sri Lanka. Caries Research.

 

  1. By C.B.Dissanayake. Use of geochemical data banks in monitoring the natural environment — a case study from Sri Lanka. Environment International.